January 2021 Cases Of The Week

Case of the week from 1/31/2021

History: History of left breast cancer. Preoperative
What kind of study is this? Sentinel node study (lymphoscintigraphy) with cobalt screen.
What are the findings? No sentinel lymph nodes in the axilla.
What do you do next in this situation? Communicate the results to the surgeon. Typically, they will go ahead with the surgery regardless of a negative study because they can check for lymph nodes real time that you might not see at the time of the lymphoscintigraphy.

Case of the week from 1/24/2021

History: Blurry vision. History of facial injury two weeks ago.
What are the findings? Bilateral pterygoid fractures, medial orbital wall, and maxillary floor fractures. Injury to the pterygoids may explain patients symptoms.
What do you need to tell the ordering physician? Findings consistent with a LeFort 1 type fracture. May need surgical intervention. Surgical consultation recommended.

Case of the week from 1/17/2021

History: History of breast cancer.
What are the findings? Calvarial lesion, vertebral lesions, rib lesion, suspicious for metastatic disease. Additionally, there is a moderately MDP active soft tissue at the upper abdomen.
What is the correlate on the CT scan and why? MDP soft tissue lesion corresponding to the hepatic mass on abdominal CT scan, likely due to increased flow given absent calcification.

Case of the week from 1/10/2021

History: Knee pain.
What is the specific diagnosis? Medical meniscal radial tear.
How is the diagnosis treated? No consensus on the optimal treatment due to increased severity. More functionally like a total meniscectomy. Some surgeons will try to repair them but gold standard in the past was to perform a partial or total meniscectomy to relieve symptoms.